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Augusto JF, Beauvillain C, Poli C, Paolini L, Tournier I, Pignon P, Blanchard S, Preisser L, Soleti R, Delépine C, Monnier M, Douchet I, Asfar P, Beloncle F, Guisset O, Prével R, Mercat A, Vinatier E, Goret J, Subra JF, Couez D, Wilson MR, Blanco P, Jeannin P, Delneste Y. Clusterin Neutralizes the Inflammatory and Cytotoxic Properties of Extracellular Histones in Sepsis. Am J Respir Crit Care Med 2023; 208:176-187. [PMID: 37141109 DOI: 10.1164/rccm.202207-1253oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 05/03/2023] [Indexed: 05/05/2023] Open
Abstract
Rationale: Extracellular histones, released into the surrounding environment during extensive cell death, promote inflammation and cell death, and these deleterious roles have been well documented in sepsis. Clusterin (CLU) is a ubiquitous extracellular protein that chaperones misfolded proteins and promotes their removal. Objectives: We investigated whether CLU could protect against the deleterious properties of histones. Methods: We assessed CLU and histone expression in patients with sepsis and evaluated the protective role of CLU against histones in in vitro assays and in vivo models of experimental sepsis. Measurements and Main Results: We show that CLU binds to circulating histones and reduces their inflammatory, thrombotic, and cytotoxic properties. We observed that plasma CLU levels decreased in patients with sepsis and that the decrease was greater and more durable in nonsurvivors than in survivors. Accordingly, CLU deficiency was associated with increased mortality in mouse models of sepsis and endotoxemia. Finally, CLU supplementation improved mouse survival in a sepsis model. Conclusions: This study identifies CLU as a central endogenous histone-neutralizing molecule and suggests that, in pathologies with extensive cell death, CLU supplementation may improve disease tolerance and host survival.
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Affiliation(s)
- Jean-François Augusto
- Univ Angers, Nantes Université, INSERM, CNRS, CRCI2ICAT, Angers, France
- Département de Néphrologie, Dialyse et Transplantation
| | - Céline Beauvillain
- Univ Angers, Nantes Université, INSERM, CNRS, CRCIICAT, Angers, France
- Laboratoire d'Immunologie et Allergologie, and
| | - Caroline Poli
- Univ Angers, Nantes Université, INSERM, CNRS, CRCIICAT, Angers, France
- Laboratoire d'Immunologie et Allergologie, and
| | - Léa Paolini
- Univ Angers, Nantes Université, INSERM, CNRS, CRCIICAT, Angers, France
| | - Isabelle Tournier
- Univ Angers, Nantes Université, INSERM, CNRS, CRCIICAT, Angers, France
- Institut de Cancérologie de l'Ouest, Angers, France
| | - Pascale Pignon
- Univ Angers, Nantes Université, INSERM, CNRS, CRCIICAT, Angers, France
| | - Simon Blanchard
- Univ Angers, Nantes Université, INSERM, CNRS, CRCIICAT, Angers, France
- Laboratoire d'Immunologie et Allergologie, and
| | - Laurence Preisser
- Univ Angers, Nantes Université, INSERM, CNRS, CRCIICAT, Angers, France
| | - Raffaella Soleti
- Univ Angers, Nantes Université, INSERM, CNRS, CRCIICAT, Angers, France
| | - Chloé Delépine
- Univ Angers, Nantes Université, INSERM, CNRS, CRCIICAT, Angers, France
| | - Marine Monnier
- Univ Angers, Nantes Université, INSERM, CNRS, CRCIICAT, Angers, France
| | - Isabelle Douchet
- UMR-CNRS, ImmunConcept, University of Bordeaux, Bordeaux, France
| | - Pierre Asfar
- Service de Médecine Intensive et Réanimation, CHU d'Angers, Angers, France
- Université de Angers, Inserm, CNRS, MITOVASC, SFR ICAT, Angers, France
| | - François Beloncle
- Service de Médecine Intensive et Réanimation, CHU d'Angers, Angers, France
| | | | | | - Alain Mercat
- UMR-CNRS, ImmunConcept, University of Bordeaux, Bordeaux, France
| | - Emeline Vinatier
- Univ Angers, Nantes Université, INSERM, CNRS, CRCIICAT, Angers, France
- Laboratoire d'Immunologie et Allergologie, and
| | - Julien Goret
- UMR-CNRS, ImmunConcept, University of Bordeaux, Bordeaux, France
- Department of Immunology and Immunogenetics, Bordeaux University Hospital, Bordeaux, France
| | - Jean-François Subra
- Univ Angers, Nantes Université, INSERM, CNRS, CRCIICAT, Angers, France
- Département de Néphrologie, Dialyse et Transplantation
| | - Dominique Couez
- Univ Angers, Nantes Université, INSERM, CNRS, CRCIICAT, Angers, France
| | - Mark R Wilson
- Molecular Horizons and School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, New South Wales, Australia; and
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Patrick Blanco
- UMR-CNRS, ImmunConcept, University of Bordeaux, Bordeaux, France
- Department of Immunology and Immunogenetics, Bordeaux University Hospital, Bordeaux, France
| | - Pascale Jeannin
- Univ Angers, Nantes Université, INSERM, CNRS, CRCIICAT, Angers, France
- Laboratoire d'Immunologie et Allergologie, and
| | - Yves Delneste
- Univ Angers, Nantes Université, INSERM, CNRS, CRCIICAT, Angers, France
- Laboratoire d'Immunologie et Allergologie, and
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2
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Maral M, Erdem A. Carbon Nanofiber-Ionic Liquid Nanocomposite Modified Aptasensors Developed for Electrochemical Investigation of Interaction of Aptamer/Aptamer-Antisense Pair with Activated Protein C. BIOSENSORS 2023; 13:bios13040458. [PMID: 37185533 PMCID: PMC10136435 DOI: 10.3390/bios13040458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 05/17/2023]
Abstract
Selective and sensitive detection of human activated protein C (APC) was performed herein by using carbon nanofiber (CNF) and ionic liquid (IL) composite modified pencil graphite electrode (PGE) and electrochemical impedance spectroscopy (EIS) technique. A carbon nanomaterial-based electrochemical aptasensor was designed and implemented for the first time in this study for the solution-phase interaction of DNA-Apt with its cognate protein APC as well as APC inhibitor aptamer-antidote pair. The applicability of this assay developed for the determination of APC in fetal bovine serum (FBS) and its selectivity against different proteins (protein C, thrombin, bovine serum albumin) was also examined. CNF-IL modified aptasensor specific to APC provided the detection limit as 0.23 μg/mL (equal to 3.83 nM) in buffer medium and 0.11 μg/mL (equal to 1.83 nM) in FBS. The duration of the proposed assay from the point of electrode modification to the detection of APC was completed within only 55 min.
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Affiliation(s)
- Meltem Maral
- Department of Material Science and Engineering, The Institute of Natural and Applied Sciences, Ege University, Bornova, 35100 Izmir, Turkey
- Analytical Chemistry Department, Faculty of Pharmacy, Ege University, Bornova, 35100 Izmir, Turkey
| | - Arzum Erdem
- Department of Material Science and Engineering, The Institute of Natural and Applied Sciences, Ege University, Bornova, 35100 Izmir, Turkey
- Analytical Chemistry Department, Faculty of Pharmacy, Ege University, Bornova, 35100 Izmir, Turkey
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3
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Steiner SE, Edgren G, Melican K, Richter-Dahlfors A, Brauner A. Effect of anticoagulant and platelet inhibition on the risk of bacteremia among patients with acute pyelonephritis: a retrospective cohort study. BMC Infect Dis 2022; 22:509. [PMID: 35641940 PMCID: PMC9158213 DOI: 10.1186/s12879-022-07474-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/16/2022] [Indexed: 11/21/2022] Open
Abstract
Background An increasing number of patients are being prescribed anticoagulants and platelet inhibitors (antithrombotic treatment). Basic research has suggested an association between antithrombotic treatment and bacteremia during kidney infection. Here, we investigated the association between antithrombotic treatment, bacteremia and acute kidney injury in patients with acute pyelonephritis. Methods A retrospective cohort study was conducted in a large university hospital in Sweden. Data were retrieved from electronic medical records for adult patients with acute pyelonephritis in 2016. The main outcome was bacteremia and secondary outcome acute kidney injury. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated through multiple logistic regression. Treatment with different groups of antithrombotic agents were compared to no antithrombotic treatment. Results 1814 patients with acute pyelonephritis were included, in whom bacteremia developed in 336 (18.5%). Low-molecular-weight heparin (LMWH) at prophylactic doses was associated with a lower risk of bacteremia, compared to no antithrombotic treatment (OR 0.5; 95% CI 0.3–0.7). Other antithrombotic treatments were not associated with a risk of bacteremia. Additionally, patients with prophylactic doses of LMWH had a lower risk of acute kidney injury (OR 0.5; 95% CI 0.3–0.8). Conclusions We found no association between antithrombotic treatment and an increased risk of bacteremia during acute pyelonephritis. Conversely, patients with prophylactic doses of LMWH had a slightly reduced risk of bacteremia. LMWH at prophylactic doses was also associated with a lower risk of acute kidney injury. Our results suggest that it is safe to continue antithrombotic treatment during acute pyelonephritis, in regards to bacteremia and acute kidney injury risk. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07474-4.
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Affiliation(s)
- Svava E Steiner
- AIMES - Center for the Advancement of Integrated Medical and Engineering Sciences at Karolinska Institutet and KTH Royal Institute of Technology, Stockholm, Sweden.,Department of Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Gustaf Edgren
- Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, 171 77, Stockholm, Sweden.,Department of Cardiology, Södersjukhuset, Stockholm, Sweden
| | - Keira Melican
- AIMES - Center for the Advancement of Integrated Medical and Engineering Sciences at Karolinska Institutet and KTH Royal Institute of Technology, Stockholm, Sweden.,Department of Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Agneta Richter-Dahlfors
- AIMES - Center for the Advancement of Integrated Medical and Engineering Sciences at Karolinska Institutet and KTH Royal Institute of Technology, Stockholm, Sweden.,Department of Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Annelie Brauner
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 171 77, Stockholm, Sweden. .,Division of Clinical Microbiology, Karolinska University Hospital, 171 76, Stockholm, Sweden.
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4
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Tang D, Wang H, Billiar TR, Kroemer G, Kang R. Emerging mechanisms of immunocoagulation in sepsis and septic shock. Trends Immunol 2021; 42:508-522. [PMID: 33906793 DOI: 10.1016/j.it.2021.04.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 12/11/2022]
Abstract
Sepsis and septic shock driven by microbial infections are still among the most challenging health problems, causing 11 million deaths worldwide every year. How does the host's response to pathogen infections effectively restore homeostasis instead of precipitating pathogenic and potentially fatal feedforward reactions? Recently, there have been significant new advances in our understanding of the interface between mammalian immunity and coagulation ('immunocoagulation') and its impact on sepsis. In particular, the release and activation of F3 (the main initiator of coagulation) from and on myeloid or epithelial cells is facilitated by activating inflammasomes and consequent gasdermin D (GSDMD)-mediated pyroptosis, coupled to signaling via high mobility group box 1 (HMGB1), stimulator of interferon response CGAMP interactor 1 (STING1), or sequestosome 1 (SQSTM1). Pharmacological modulation of the immunocoagulation pathways emerge as novel and potential therapeutic strategies for sepsis.
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Affiliation(s)
- Daolin Tang
- The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, China; Department of Surgery, UT Southwestern Medical Center, Dallas, TX 75390, USA.
| | - Haichao Wang
- Laboratory of Emergency Medicine, North Shore University Hospital and the Feinstein Institute for Medical Research, Manhasset, NY 11030, USA
| | - Timothy R Billiar
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Guido Kroemer
- Equipe Labellisée par la Ligue Contre le Cancer, Université de Paris, Sorbonne Université, INSERM U1138, Centre de Recherche des Cordeliers, Paris, France; Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Campus; 94800 Villejuif, France; Pôle de Biologie, Hôpital Européen Georges Pompidou, AP-, HP; 75015 Paris, France; Suzhou Institute for Systems Medicine, Chinese Academy of Sciences, Suzhou, China; Department of Women's and Children's Health, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Rui Kang
- Department of Surgery, UT Southwestern Medical Center, Dallas, TX 75390, USA.
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5
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Abstract
Endothelial cells (ECs) are vascular, nonconventional immune cells that play a major role in the systemic response after bacterial infection to limit its dissemination. Triggered by exposure to pathogens, microbial toxins, or endogenous danger signals, EC responses are polymorphous, heterogeneous, and multifaceted. During sepsis, ECs shift toward a proapoptotic, proinflammatory, proadhesive, and procoagulant phenotype. In addition, glycocalyx damage and vascular tone dysfunction impair microcirculatory blood flow, leading to organ injury and, potentially, life-threatening organ failure. This review aims to cover the current understanding of the EC adaptive or maladaptive response to acute inflammation or bacterial infection based on compelling recent basic research and therapeutic clinical trials targeting microvascular and endothelial alterations during septic shock.
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Affiliation(s)
- Jérémie Joffre
- Medical Intensive Care Unit, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France.,Department of Anesthesia and Perioperative Care, University of California San Francisco School of Medicine, San Francisco, California
| | - Judith Hellman
- Department of Anesthesia and Perioperative Care, University of California San Francisco School of Medicine, San Francisco, California
| | - Can Ince
- Department of Intensive Care Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands; and
| | - Hafid Ait-Oufella
- Medical Intensive Care Unit, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France.,INSERM U970, Cardiovascular Research Center, Université de Paris, Paris, France
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6
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Jensen JUS, Peters L, Itenov TS, Bestle M, Thormar KM, Mohr TT, Lundgren B, Grarup J, Lundgren JD. Biomarker-assisted identification of sepsis-related acute liver impairment: a frequent and deadly condition in critically ill patients. Clin Chem Lab Med 2020; 57:1422-1431. [PMID: 30951497 DOI: 10.1515/cclm-2018-1350] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/04/2019] [Indexed: 01/30/2023]
Abstract
Background The prognostic impact of mild/moderate liver impairment among critically ill patients is not known. We aimed to determine whether acute liver impairment, as measured by several biomarkers, (i) is frequent, (ii) influences prognosis and (iii) to determine whether such an effect is specific for infected critically ill patients. Methods A biomarker and clinical cohort study based on a randomized controlled trial. All-cause mortality was the primary endpoint. Biomarkers hyaluronic acid (HA), bilirubin, albumin, alkaline phosphatase and the international normalized ratio (INR) were determined. Multivariable statistics were applied to estimate risk increase according to liver biomarker increase at baseline and the model was adjusted for age, APACHE II, severe sepsis/septic shock vs. milder infection, chronic alcohol abuse Charlson's co-morbidity index, cancer disease, surgical or medical patient, body mass index, sex, estimated glomerular filtration rate, mechanical ventilation and the other biomarkers. Time-to-event graphs were used. The patients were critically ill patients (n = 1096) from nine mixed medical/surgical intensive care units without known hepatobiliary disease. Results HA levels differed between infected patients (median 210.8 ng/mL [IQR: 93.2-556.6]) vs. the non-infected (median 56.8 ng/mL [IQR: 31.9-116.8], p < 0.001). Serum HA quartiles 2, 3 and 4 were independent predictors of 90-day all-cause mortality for the entire population (infected and non-infected). However, the signal was driven by the infected patients (positive interaction test, no signal in non-infected patients). Among infected patients, HA quartiles corresponded directly to the 90-day risk of dying: 1st quartile: 57/192 = 29.7%, 2nd quartile: 84/194 = 43.3%, 3rd quartile: 90/193 = 46.6%, 4th quartile: 101/192 = 52.3 %, p for trend: <0.0001. This finding was confirmed in adjusted analyses: hazard ratio vs. 1st quartile: 2nd quartile: 1.3 [0.9-1.8], p = 0.14, 3rd quartile: 1.5 [1.1-2.2], p = 0.02, 4th quartile: 1.9 [1.3-2.6], p < 0.0001). High bilirubin was also an independent predictor of mortality. Conclusions Among infected critically ill patients, subtle liver impairment, (elevated HA and bilirubin), was associated with a progressive and highly increased risk of death for the patient; this was robust to adjustment for other predictors of mortality. HA can identify patients at high risk.
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Affiliation(s)
- Jens-Ulrik Stæhr Jensen
- CHIP & PERSIMUNE, Department of Infectious Diseases, Rigshospitalet, University Hospital of Copenhagen and University of Copenhagen, Copenhagen, Denmark.,Department of Internal Medicine C, Respiratory Medicine Section, Copenhagen University Hospital, Herlev-Gentofte, Denmark
| | - Lars Peters
- CHIP & PERSIMUNE, Department of Infectious Diseases, Rigshospitalet, University Hospital of Copenhagen and University of Copenhagen, Copenhagen, Denmark
| | - Theis S Itenov
- CHIP & PERSIMUNE, Department of Infectious Diseases, Rigshospitalet, University Hospital of Copenhagen and University of Copenhagen, Copenhagen, Denmark.,Department of Anesthesia and Intensive Care, Copenhagen University Hospital, Hillerød, Denmark
| | - Morten Bestle
- Department of Anesthesia and Intensive Care, Copenhagen University Hospital, Hillerød, Denmark.,Department of Anesthesia and Intensive Care, Copenhagen University Hospital, Glostrup, Denmark
| | - Katrin M Thormar
- Department of Anesthesia and Intensive Care, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Anesthesia and Intensive Care, Copenhagen University Hospital, Gentofte, Denmark
| | - Thomas T Mohr
- Department of Anesthesia and Intensive Care, Copenhagen University Hospital, Glostrup, Denmark.,Department of Anesthesia and Intensive Care, Copenhagen University Hospital, Gentofte, Denmark
| | - Bettina Lundgren
- Diagnostic Center, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Jesper Grarup
- CHIP & PERSIMUNE, Department of Infectious Diseases, Rigshospitalet, University Hospital of Copenhagen and University of Copenhagen, Copenhagen, Denmark
| | - Jens D Lundgren
- CHIP & PERSIMUNE, Department of Infectious Diseases, Rigshospitalet, University Hospital of Copenhagen and University of Copenhagen, Copenhagen, Denmark
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7
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Oto J, Fernández-Pardo Á, Miralles M, Plana E, España F, Navarro S, Medina P. Activated protein C assays: A review. Clin Chim Acta 2020; 502:227-232. [DOI: 10.1016/j.cca.2019.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/31/2019] [Accepted: 11/04/2019] [Indexed: 01/16/2023]
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8
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Evans CE, Zhao YY. Impact of thrombosis on pulmonary endothelial injury and repair following sepsis. Am J Physiol Lung Cell Mol Physiol 2017; 312:L441-L451. [PMID: 28130261 PMCID: PMC5407094 DOI: 10.1152/ajplung.00441.2016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 12/20/2016] [Accepted: 01/19/2017] [Indexed: 12/19/2022] Open
Abstract
The prevailing morbidity and mortality in sepsis are largely due to multiple organ dysfunction (MOD), most commonly lung injury, as well as renal and cardiac dysfunction. Despite recent advances in defining many aspects of the pathogenesis of sepsis-related MOD, including acute respiratory distress syndrome (ARDS), there are currently no effective pharmacological or cell-based treatments for the disease. Human and animal studies have shown that pulmonary thrombosis is common in sepsis-induced ARDS, and preclinical studies have shown that anticoagulation may improve outcome following sepsis challenge. The potential beneficial effect of anticoagulation on outcome is unconvincing in clinical studies, however, and these discrepancies may arise from the multiple and sometimes opposing actions of thrombosis on the pulmonary endothelium following sepsis. It has been suggested, for example, that mild pulmonary thrombosis prevents escape of bacterial infection into the circulation, while severe thrombosis causes hypoxia and results in pulmonary endothelial damage. Evidence from both human and animal studies has demonstrated the key role of microvascular leakage in determining the outcome of sepsis. In this review, we describe thrombosis-dependent mechanisms that regulate pulmonary endothelial injury and repair following sepsis, including activation of the coagulation cascade by tissue factor and stimulation of vascular repair by hypoxia-inducible factors. Targeting such mechanisms through anticoagulant, anti-inflammatory, and reparative methods may represent a novel approach for the treatment of septic patients.
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Affiliation(s)
- Colin E Evans
- Department of Pharmacology, University of Illinois at Chicago, College of Medicine, Chicago, Illinois; and
- Center for Lung and Vascular Biology, University of Illinois at Chicago, College of Medicine, Chicago, Illinois
| | - You-Yang Zhao
- Department of Pharmacology, University of Illinois at Chicago, College of Medicine, Chicago, Illinois; and
- Center for Lung and Vascular Biology, University of Illinois at Chicago, College of Medicine, Chicago, Illinois
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9
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Carnemolla R, Villa CH, Greineder CF, Zaitsev S, Patel KR, Kowalska MA, Atochin DN, Cines DB, Siegel DL, Esmon CT, Muzykantov VR. Targeting thrombomodulin to circulating red blood cells augments its protective effects in models of endotoxemia and ischemia-reperfusion injury. FASEB J 2016; 31:761-770. [PMID: 27836986 DOI: 10.1096/fj.201600912r] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 10/24/2016] [Indexed: 12/11/2022]
Abstract
Endothelial thrombomodulin (TM) regulates coagulation and inflammation via several mechanisms, including production of activated protein C (APC). Recombinant APC and soluble fragments of TM (sTM) have been tested in settings associated with insufficiency of the endogenous TM/APC pathway, such as sepsis. We previously designed a fusion protein of TM [single-chain variable fragment antibody (scFv)/TM] targeted to red blood cells (RBCs) to improve pharmacokinetics and antithrombotic effects without increasing bleeding. Here, scFv/TM was studied in mouse models of systemic inflammation and ischemia-reperfusion injury. Injected concomitantly with or before endotoxin, scFv/TM provided more potent protection against liver injury and release of pathological mediators than sTM, showing similar efficacy at up to 50-fold lower doses. scFv/TM provided protection when injected after endotoxin, whereas sTM did not, and augmented APC production by thrombin ∼50-fold more than sTM. However, scFv/TM injected after endotoxin did not reduce thrombin/antithrombin complexes; nor did antibodies that block APC anticoagulant activity suppress the prophylactic anti-inflammatory effect of scFv/TM. Therefore, similar to endogenous TM, RBC-anchored scFv/TM activates several protective pathways. Finally, scFv/TM was more effective at reducing cerebral infarct volume and alleviated neurological deficits than sTM after cerebral ischemia/reperfusion injury. These results indicate that RBC-targeted scFv/TM exerts multifaceted cytoprotective effects and may find utility in systemic and focal inflammatory and ischemic disorders.-Carnemolla, R., Villa, C. H., Greineder, C. F., Zaitseva, S., Patel, K. R., Kowalska, M. A., Atochin, D. N., Cines, D. B., Siegel, D. L., Esmon, C. T., Muzykantov, V. R. Targeting thrombomodulin to circulating red blood cells augments its protective effects in models of endotoxemia and ischemia-reperfusion injury.
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Affiliation(s)
- Ronald Carnemolla
- Department of Pharmacology, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; USA.,Center for Targeted Therapeutics and Translational Nanomedicine, Institute for Translational Medicine and Therapeutics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; USA
| | - Carlos H Villa
- Department of Pharmacology, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; USA.,Center for Targeted Therapeutics and Translational Nanomedicine, Institute for Translational Medicine and Therapeutics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; USA.,Department of Pathology and Laboratory Medicine, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; USA
| | - Colin F Greineder
- Department of Pharmacology, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; USA.,Center for Targeted Therapeutics and Translational Nanomedicine, Institute for Translational Medicine and Therapeutics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; USA
| | - Sergei Zaitsev
- Department of Pharmacology, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; USA.,Center for Targeted Therapeutics and Translational Nanomedicine, Institute for Translational Medicine and Therapeutics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; USA.,Department of Pathology and Laboratory Medicine, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; USA
| | - Kruti R Patel
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - M Anna Kowalska
- Division of Hematology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Institute of Medical Biology, Polish Academy of Sciences, Lodz, Poland
| | - Dmitriy N Atochin
- Division of Cardiology, Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - Douglas B Cines
- Department of Pathology and Laboratory Medicine, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; USA
| | - Don L Siegel
- Department of Pathology and Laboratory Medicine, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; USA
| | - Charles T Esmon
- Department of Pathology, Coagulation Biology Laboratory, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA; and.,Department of Biochemistry and Molecular Biology, Coagulation Biology Laboratory, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | - Vladimir R Muzykantov
- Department of Pharmacology, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; USA; .,Center for Targeted Therapeutics and Translational Nanomedicine, Institute for Translational Medicine and Therapeutics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; USA
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10
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Martos L, Bonanad S, Ramón LA, Cid AR, Bonet E, Corral J, Miralles M, España F, Navarro S, Medina P. A simplified assay for the quantification of circulating activated protein C. Clin Chim Acta 2016; 459:101-104. [DOI: 10.1016/j.cca.2016.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 05/26/2016] [Accepted: 05/27/2016] [Indexed: 10/21/2022]
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11
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Lin C, von der Thüsen J, Isermann B, Weiler H, van der Poll T, Borensztajn K, Spek CA. High endogenous activated protein C levels attenuates bleomycin-induced pulmonary fibrosis. J Cell Mol Med 2016; 20:2029-2035. [PMID: 27295971 PMCID: PMC5082406 DOI: 10.1111/jcmm.12891] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/02/2016] [Indexed: 01/13/2023] Open
Abstract
Coagulation activation accompanied by reduced anticoagulant activity is a key characteristic of patients with idiopathic pulmonary fibrosis (IPF). Although the importance of coagulation activation in IPF is well studied, the potential relevance of endogenous anticoagulant activity in IPF progression remains elusive. We assess the importance of the endogenous anticoagulant protein C pathway on disease progression during bleomycin‐induced pulmonary fibrosis. Wild‐type mice and mice with high endogenous activated protein C APC levels (APChigh) were subjected to bleomycin‐induced pulmonary fibrosis. Fibrosis was assesses by hydroxyproline and histochemical analysis. Macrophage recruitment was assessed immunohistochemically. In vitro, macrophage migration was analysed by transwell migration assays. Fourteen days after bleomycin instillation, APChigh mice developed pulmonary fibrosis to a similar degree as wild‐type mice. Interestingly, Aschcroft scores as well as lung hydroxyproline levels were significantly lower in APChigh mice than in wild‐type mice on day 28. The reduction in fibrosis in APChigh mice was accompanied by reduced macrophage numbers in their lungs and subsequent in vitro experiments showed that APC inhibits thrombin‐dependent macrophage migration. Our data suggest that high endogenous APC levels inhibit the progression of bleomycin‐induced pulmonary fibrosis and that APC modifies pulmonary fibrosis by limiting thrombin‐dependent macrophage recruitment.
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Affiliation(s)
- Cong Lin
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Jan von der Thüsen
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Berend Isermann
- Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Germany
| | - Hartmut Weiler
- Department of Physiology, BloodCenter of Wisconsin, Milwaukee, WI, USA
| | - Tom van der Poll
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Keren Borensztajn
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam, The Netherlands.,Inserm UMR1152, Medical School Xavier Bichat, Paris, France.,Département Hospitalo-universtaire FIRE (Fibrosis Inflammation and Remodeling) and LabEx Inflamex, Paris, France
| | - Chris A Spek
- Center for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam, The Netherlands.
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